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研究生:阮氏福
研究生(外文):NGUYEN THI PHUOC
論文名稱:探讨慢性透析患者的生活质量
論文名稱(外文):An Exploration of Quality of Life in Patients with Hemodialysis
指導教授:張淑媛張淑媛引用關係
指導教授(外文):SHU-YUAN CHANG
口試委員:方莉陳柏 話
口試委員(外文):LI FANGTRAN BA THOAI
口試日期:2019-07-24
學位類別:碩士
校院名稱:輔英科技大學
系所名稱:護理系碩士班
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2019
畢業學年度:108
語文別:英文
論文頁數:61
中文關鍵詞:血液透析生活質量
外文關鍵詞:HemodialysisQuality of life
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血液透析患者生活品質的探討
摘要
研究背景:
血液透析廣泛用於越南的腎臟病房。 血液透析治療使得患者失去自由、變得依賴、婚姻失敗、經濟收入降低,同時大大地影響患者的生活品質。
研究目的:
本研究的目的是調查生活質量與血液透析患者特徵之間的關係。
研究方法:
本研究是採橫斷式研究設計方法分析98名廣南綜合醫院的血液透析患者,研究使用具有良好的信度及效度之越南版Short-36(SF-36)結構問卷為工具,以描述性統計及推論性研究進行人口學統計及數據分析、時間從2019年2月到2019年7月。
研究結果:
廣南綜合醫院之血液透析患者在身體健康和心理健康領域比一般人得分低很多,具體來說:物理成分總量(PCS)為34.38、心理健康概要(MCS)為41.35;身體功能的八個健康領域(PF)38.9、角色物理(RP)33.29、身體疼痛(BP)40.19、一般健康(GH)27.58、活力(VT)38.48、社會功能(SF)38.49、角色情感(RE)38.17、心理健康(MH)42.55 ;其中物理構成總量(PCS)比一般人低(89%)、心理健康狀態較一般人(61%)低。8個健康領域標準是接近一般人(≥56%),血液透析患者約54%有憂鬱症風險、一般人約只佔18%, 性別與憂鬱症風險之間呈現女性(70%)患憂鬱症的風險高於男性(45%)。
研究結論:
透過分析越南廣南省總醫院98例血液透析患者的生活質量發現,血液透析患者的生活質量比一般人低很多。 為了改善患者的生活質量,應加強包括溝通和教育。由於這項研究的局限在廣南綜合醫院、無法衡量其他患者在不同時間的生活質量,本研究結果期望能提供相關機構及政策單位在提昇血液透析患者 生活品質策略之參考。

關鍵詞:血液透析,生活質量。

ABSTRACT
Background:
Hemodialysis is widely used at the renal world in Vietnam. Treatment of hemodialysis prolongs the life of patients who have lost their freedom, depend on caregivers, failed marriages, reduction or loss of financial income, which greatly affect their quality of life.
Aim:
The purpose of this study was to survey the relationship between quality of life and characteristics of hemodialysis patients.
Methods:
A cross-sectional analysis with structural questionnaires design was used. The measures included demographic data and Vietnam versions of Short Form-36 (SF-36). 98 hemodialysis patients at Quang Nam General Hospital were participated in this research from February 2019 to July 2019. Data were analyzed by descriptive statistics by percentage,
Results:
Hemodialysis patients in Guangnan General Hospital scored much lower than the average person in physical health and mental health, specifically: total physical composition summary (PCS) was 34.38, mental health summary (MCS) was 41.35; eight health of body function Field (PF) 38.9, role physics (RP) 33.29, body pain (BP) 40.19, general health (GH) 27.58, vitality (VT) 38.48, social function (SF) 38.49, role emotion (RE) 38.17, mental health ( MH) 42.55; the total physical composition (PCS) is lower than the average person (89%), and the mental health status is lower than the average person (61%). The eight health sector standards are close to the average person (≥56%), about 54% of hemodialysis patients have a risk of depression, the average person only accounts for 18%, and the risk of depression (70%) among women and depression risk Higher than men (45%).


Conclusion:
By analyzing the quality of life of 98 hemodialysis patients in the General Hospital of Guangnan Province, Vietnam, the quality of life of hemodialysis patients was much lower than that of the average person. In order to improve the quality of life of patients, it should be strengthened to include communication and education. Since the study is limited to the Guangnan General Hospital and cannot measure the quality of life of other patients at different times, the results of this study are expected to provide reference for relevant institutions and policy units to improve the quality of life of the hemodialysis patients.

Keywords: Hemodialysis, quality of life

TABLE OF CONTENTS

CHAPTER 1. INTRODUCTION 1
1.1 STATEMENT OF THE PROBLEM 1
1.2 PREVALENCE OF CHRONIC RENAL FAILURE LATE STAGE 3
1.3 PURPOSE OF THE STUDY 3
1.4 RESEARCH QUESTIONS 4
1.5 DEFINITION, CONCEPTS RELATED TO RESEARCH TOPICS 4
1.5.1 Chronic kidney failure 4
1.5.2 Hemodialysis 4
1.5.3 Quality of life 5
CHAPTER 2. LITERATURE REVIEW 6
2.1 THE CHRONIC DIALYSIS FOR THE TREATMENT OF END-STAGE CHRONIC RENAL FAILURE 6
2.1.1 Principles of dialysis 6
2.1.2 Adsorption 7
2.1.3 Factors affecting the effectiveness of dialysis 7
2.1.4 Blood vessels in hemodialysis 7
2.1.5 Indication and contraindication to hemodialysis 8
2.1.6 Primary dialysis methods by hemodialysis 9
2.2 QUALITY OF LIFE AND FACTORS ASSOCIATED WITH PATIENTS WITH END-STAGE RENAL ON HEMODIALYSIS 11
2.3 SF-36V2 HEALTH SURVEY 13
2.3.1 Introduction 13
2.3.2 Concepts, Measures, and Applications 15
CHAPTER 3. METHODOLOGY 24
3.1 RESEARCH DESIGN: 24
CONCEPTUAL FRAMEWORK: 25
3.2 SAMPLING & SETTING: 25
3.2.1 Sample size selection method: 25
3.2.2 Selection criteria: 26
3.3 EXCLUSION CRITERIA: 26
3.4 INSTRUMENTS: 27
3.5 PROCESS OF QUESTIONNAIRE TRANSLATION 27
3.6 DATA COLLECTION: 27
3.6.1 Research process: 28
Data collection process: 28
3.6.2 Scoring the SF-36v2 30
3.6.3 Health Outcomes Scoring Software 1.3 34
3.7 ETHICAL CONSIDERATION: 35
3.8 DATA ANALYSIS: 36
3.8.1 Quantitative Evaluation of Data Quality 36
3.8.2 Evaluate correlation level by correlation coefficient “r” 37
3.8.3 General Considerations for Norm- Based Interpretation 37
3.9 IMPLEMENTATION FUNDING: 38
3.10 SUMMARY: 39
CHAPTER 4. RESULT 40
4.1 SURVEY THE QUALITY OF LIFE OF HEMODIALYSIS PATIENTS 40
4.1.1 Characteristics of hemodialysis patients 40
4.1.2 Scores for quality of life in hemodialysis patients 41
4.1.3 Risk of depression (%) 42
4.1.4 Sample whose scores "Above" "At" or "Below" The General Population Norm of PCS and MCS scales (%) 43
4.1.5 Sample whose scores "Above" "At" or "Below" the General Population Norm of 08 Health Scales (%) 44
4.2 THE RELATIONSHIP BETWEEN QUALITY OF LIFE AND CHARACTERISTICS IN HEMODIALYSIS PATIENTS 45
4.2.1 The relationship between PCS and MCS scores with Age Group 45
4.2.2 Relationship between scales scores with Gender 46
4.2.3 The relationship between PCS score and MCS score with Gender 47
4.2.4 The relationship between gender and % risk First stage Positive depression 48
5.1 SURVEY THE QUALITY OF LIFE OF HEMODIALYSIS PATIENTS 49
5.1.1 Characteristics of hemodialysis patients 49
5.1.2 Scores for quality of life in hemodialysis patients 49
5.1.3 At risk first positive depression 50
5.1.4 Sample whose scores "Above" "At" or "Below" The General Population Norm of PCS and MCS scales (%) 51
5.1.5 Sample whose scores "Above" "At" or "Below" The General Population Norm of 08 Health Scales (%) 52
5.2 THE RELATIONSHIP BETWEEN QUALITY OF LIFE AND CHARACTERISTICS IN HEMODIALYSIS PATIENTS 53
5.2.1 The relationship between PCS and MCS scores with Age Group 53
5.2.2 Relationship between scales scores with Gender 54
5.2.3 The relationship between % of respondents with PCS and MCS points: "Above", "At", or "Below" averages with gender 54
5.2.4 The relationship between gender and % risk First stage Positive depression 55
CHAPTER 6. CONCLUSION 56
6.1 SURVEYING THE QUALITY OF LIFE IN HEMODIALYSIS PATIENTS 56
6.2 THE RELATIONSHIP BETWEEN QUALITY OF LIFE AND SOME CHARACTERISTICS OF HEMODIALYSIS PATIENTS 57
6.3 LIMITATION: 58
6.4 IMPLEMENTATION: 58
REFERENCES 59


LIST OF TABLES

Table 2.1: Abbreviated Item Content for the SF-36v2 Health Domain Scales 18
Table 2.2: Comparison of Features of SF-36v2 Health Domain Scales and Component Summary Measures Based on 2009 U.S. General Population Data 20
Table 2.3: Comparison of the Number of Items and Levels of Measurement for Each Component Summary Measure and Health Domain Scale for the SF-8, SF-12v2, and SF-36v2 22
Table 3.1: Research plan 24
Table 3.2: SF-36v2 Quantitative Data Quality Indicators 37


LIST OF FIGURES

Figure 2. 1: There are 2 diffused principles, ultrafiltration 6
Figure 2. 2: Connecting circulation outside the body 8
Figure 2. 3: Domains relevant to quality of life according to Felce and Perry (1995) 12
Figure 2. 4: SF-36v2 Measurement Mode 21
Figure 3. 1: The Conceptual Framework 25
Figure 3. 2: Figrure 3.1: Software Use software G * Power 3.19.2 26
Figure 3. 3: The research process 28
Figure 3. 4: Data collection process 29
Figure 3. 5: The scoring process 30
Figure 3. 6 Enter SF36V2 scores by PRO CoRE Software 34
Figure 3. 7: Score record from PRO CoRE software 1.3 34
Figure 3. 8: Source: John E.Ware, Jr; PhD 2011, Chapter 4 38
Figure 4. 1: Scores for quality of life in hemodialysis patients 40
Figure 4. 2: Scores for quality of life in hemodialysis patients 41
Figure 4. 3: Risk of depression (%) 42
Figure 4. 4: Sample whose scores "Above" "At" or "Below" The General Population Norm of PCS and MCS scales (%) 43
Figure 4. 5: Sample whose scores "Above" "At" or "Below" the General Population Norm of 08 Health Scales (%) 44
Figure 4. 6: The relationship between PCS and MCS scores with Age Group 45
Figure 4. 7: Relationship between scales scores with Gender 46
Figure 4. 8: The relationship between PCS score and MCS score with Gender 47
Figure 4. 9: The relationship between gender and % risk First stage Positive depression 48


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